Week 6 | Caring for the Patient with Obesity (15171-SP)

Photo of nurse measuring the abdomen of a male patient.

Content Outline

  • Scope of the obesity problem
    • Definitions
      • Obesity: lifelong, progressive, life threatening, genetically related, multifactorial disease of excess fat storage (American Society of Bariatric Surgery).
      • Bariatrics: The branch of medicine that deals with the causes, prevention and treatment of obesity.
    • Body Mass Index (BMI): An adult’s weight in relation to his or her height. BMI = weight in kg ÷ (height in meters)2
      • BMI of < 18.5 = Underweight
      • BMI of 18.5-24.9 = Normal weight
      • BMI of 25-29.9 = Overweight
      • BMI of 30-34.9 = Obesity Class I
      • BMI of 35-39.9 = Obesity Class II
      • BMI of 40-49.9 = Obesity Class III
  • Obesity trends 
    • Adults 
    • Gender specific 
    • Children and adolescents 
    • Racial and ethnic groups 
  • Medical complications of obesity 
    • Type 2 diabetes 
    • Hypertension 
    • Dyslipidemia 
    •  Ischemic heart disease 
    • Stroke 
    • Obstructive sleep apnea 
    • Asthma 
    • Nonalcoholic steatohepatitis (fatty liver disease) 
    • GERD
    • Degenerative joint disease 
    • Infertility 
    • Polycystic ovarian disease 
    • Metabolic syndrome 
    • Stress urinary incontinence 
    • Venous disease 
    • Depression 
    • Gallstones 
    • Skin ulcers and infection 
  • Weight bias 
    • Stereotypes and psychological impact 
    • Impact on care 
  • Environmental concerns 
    • Language 
    • Appropriate sized medical equipment/setting 
    • Safe patient handling 
    • Bariatric body dynamics: implications for care 
      • Apple or apple ascites 
      • ​Apple pannus distribution 
      • ​Pear abducted distribution 
      • Pear adducted distribution 
    • Bulbous gluteal region 
    •  Abdominal pannus
      • Care issues 
      • Pannus grading system 
  • Obesity and skin issues 
    • Risk factors 
    • Cutaneous manifestations: implications for care 
      • Acanthosis Nigricans 
      • Skin tags 
      • Striae Distensae 
      • Intertrigo 
        • Prevention 
        • Skin fold management 
      • Lypmhedema/Elephantiasis Nostra 
      • Venous ulcers 
      • Pressure ulcers 
      • Surgical wounds 
  • Obesity treatment 
    • Treatment options 
    • Selection criteria 
    • Surgical treatment 
      •  Indications 
        • BMI >40 kg/m2 
        • BMI 35Ð39.9 kg/m2 and life-threatening cardiopulmonary disease, severe diabetes, or lifestyle impairment 
        • Failure to achieve adequate weight loss with nonsurgical treatment
      • Contraindications
        • History of noncompliance with medical care 
        • Certain psychiatric illnesses: personality disorder, uncontrolled        depression, suicidal ideation, substance abuse 
        • Unlikely to survive surgery 
      • Surgical options
        • Purely Restrictive 
          • Laparoscopic adjustable gastric banding (LAGB) 
          • Sleeve Gastrectomy
        • Restrictive > Malabsorptive: Roux-en-Y gastric bypass (RYGB) 
        • Malabsorptive > Restrictive: Biliopancreatic diversion w/ duodenal  switch (BPD-DS) 
      • Complications
      • Outcomes 

Objectives for Learning Outcomes

At the end of this course work the learner will be able to:

  1. Discuss the scope of obesity as a major health problem. 
  2. Discuss weight bias and its impact on the obese individual.  
  3. Describe environmental concerns for safe patient handling. 
  4. Describe common skin issues in the bariatric population. 
  5. Identify options for obesity management. 

Additional Information

Format: 
Video
Course summary
Available: 
06/19/2015
Expires: 
08/05/2016

Renee Anderson, MSN, RN, CWON
Certified Wound and Ostomy Care Nurse; Co‐Director, Wound Management Education Program, University of Washington School of Nursing , Seattle; Clinical Faculty, Biobehavioral Nursing & Health Systems University of Washington School of Nursing; President, Rainier Clinical Consultants, Inc., Seattle, WA

 

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